Carbon monoxide poisoning during ice storms: a tale of two cities

This is a retrospective case series conducted at two university hospital emergency departments of 68 patients with a discharge diagnosis of carbon monoxide (CO) poisoning presenting during two different ice storms (March 1991 and February 1994) in two cities (Rochester, NY, and Nashville, TN). Fifty-five patients were seen over 10 d in Rochester and 13 patients over 4 d in Nashville. The main sources of CO exposure were the indoor use of gasoline generators (40 patients), propane or kerosene heaters (9 patients), and charcoal grills (8 patients). Six patients did not speak English fluently (5 Asian patients in Nashville and 1 Greek patient in Rochester). The use of charcoal grills was the most common CO source in Nashville, occurring exclusively in patients of Asian descent, 5 of whom did not speak English. In Rochester, the use of gas generators was the most common CO source. Ice storms represent a significant threat to populations affected by prolonged power outages. Different cities will be affected in different ways. When ice storms occur, the media should distribute information about potential sources of CO exposure. In some cases, the message may need to be distributed by alternative methods to populations who do not speak English or do not have access to mainstream media.